Provider Demographics
NPI:1508141193
Name:HUANG, KUO-JUI (LIC A)
Entity Type:Individual
Prefix:
First Name:KUO-JUI
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:LIC A
Other - Prefix:
Other - First Name:GARY
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LIC A
Mailing Address - Street 1:10325 S TANTAU AVE
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3547
Mailing Address - Country:US
Mailing Address - Phone:408-391-1330
Mailing Address - Fax:
Practice Address - Street 1:10325 S. TANTAU AVE.
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014
Practice Address - Country:US
Practice Address - Phone:408-391-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist